@layout("/common/_form.html",{js:["/assets/modular/system/btyYhkbg/btyYhkbg_edit.js"]}){

<form class="layui-form" id="btyYhkbgForm" lay-filter="btyYhkbgForm">
    <div class="layui-fluid" style="padding-bottom: 75px;">
        <div class="layui-card">
            <div class="layui-card-header">基本信息</div>
            <div class="layui-card-body">
                <div class="layui-form-item layui-row">
                    <input name="id" type="hidden"/>

                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">申请人<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="sqr" name="sqr" placeholder="请输入申请人" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">申请人电话<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="phone" name="phone" placeholder="请输入申请人电话" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">银行卡用途<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="yhkyt" name="yhkyt" placeholder="请输入银行卡用途" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">图片<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="picture" name="picture" placeholder="请输入图片" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">审核状态,1->待审批，2->被驳回， 3->通过<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="status" name="status" placeholder="请输入审核状态,1->待审批，2->被驳回， 3->通过" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <div class="form-group-bottom text-center">
        <button class="layui-btn" lay-filter="btnSubmit" lay-submit>&emsp;提交&emsp;</button>
        <button type="reset" class="layui-btn layui-btn-primary" id="cancel">&emsp;取消&emsp;</button>
    </div>

</form>

@}